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    Efficacy and safety of pamidronate in children with vitamin D intoxication
    (Wiley-Blackwell, 2016) Kara, Cengiz; Cetinkaya, Semra; Gunduz, Suzan; Yilmaz, Gulay Can; Aycan, Zehra; Aydin, Murat
    BackgroundBisphosphonates are used in the treatment of vitamin D intoxication (VDI) after failure of conventional therapy including prednisolone. Safety concerns restrict the use of bisphosphonates from being used as first-line therapy for VDI in children. The aim of this study was to evaluate the efficacy and safety of pamidronate in comparison with prednisolone in children with VDI. MethodsWe reviewed the hospital records of children consecutively diagnosed with VDI at two medical centers in a 15year period. ResultsThe subjects consisted of 21 children (age, 0.3-4.2years) who were treated with prednisolone and/or bisphosphonates. Pamidronate (n=18) or alendronate (n=3) was used in six patients after unsuccessful prednisolone treatment, and in 15 patients from baseline. Initial serum calcium and 25-hydroxyvitamin D were 16.11.9mg/dL and 493 +/- 219ng/mL, respectively. The median time to reach normocalcemia in the pamidronate, alendronate and prednisolone groups was 3days (range, 2-12days), 4days (range, 3-6days) and 17days (range, 12-26days), respectively (P=0.013). The pamidronate group had a fivefold shorter hospital stay than the prednisolone group. Three patients initially treated with prednisolone developed nephrocalcinosis but this did not occur in any patient treated with bisphosphonates from baseline. Apart from transient fever and moderate hypophosphatemia, no side-effect of bisphosphonate treatment was observed. ConclusionsPamidronate is efficient and safe for the treatment of VDI in children. Pamidronate use significantly shortens the duration of treatment, and thereby may prevent the development of nephrocalcinosis. Instead of prednisolone, pamidronate should be used together with hydration and furosemide as the first-line therapy for VDI.
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    Interaction of Metabolic Syndrome with Asthma in Postmenopausal Women: Role of Adipokines
    (Springer/Plenum Publishers, 2013) Aydin, Murat; Koca, Cemile; Ozol, Duygu; Uysal, Sema; Yildirim, Zeki; Kavakli, Havva Sahin; Yigitoglu, M. Ramazan
    The increasing prevalence of both asthma and obesity are major health problems. Recent studies established a possible link between obesity and asthma; however, the underlying mechanism is not clear. The aim of the study was to analyze the prevalence of metabolic syndrome in postmenopausal subjects with asthma and search the interactions between adipokines, metabolic syndrome, and asthma. A total of 45 female patients (57.5 +/- 13.9 years) with asthma and 30 healthy subjects (59.6 +/- 12.8 years) in postmenopausal status were enrolled in this study. For the diagnosis of metabolic syndrome, modified World Health Organization diagnostic criteria were used. Blood levels of glucose, lipid profile, HbA1c, insulin, CRP, leptin, adiponectin, tumor necrosis factor-alpha, interleukin (IL)-6, IL-8 and plasminogen activator inhibitor-1 (PAI-1) were measured. The mean body mass index was 29.6 +/- 5.4 for asthma patients and 28.2 +/- 5.3 for the control group. The incidence of metabolic syndrome was found as 26 % for both groups. Insulin resistance as calculated by homeostasis model assessment (HOMA-IR) and fasting insulin levels were significantly higher in asthma patients (p < 0.001 for both parameters). Leptin levels were significantly higher (p = 0.001) and adiponectin levels were lower (p = 0.029) in asthma patients compared to controls. We concluded that although incidence of obesity and metabolic syndrome was not higher in postmenopausal asthma patients than controls, there was an impairment of glucose metabolism and altered adipokine levels in asthma patients.